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=='''The PPACA and Small Business'''==
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=='''2016 Election Candidates’ Positions on the ACA'''==
The three remaining Republican candidates in the 2016 Presidential Election, Ted Cruz, John Kasich, and Donald Trump are largely united on the issue of health care reform in that they all have plans to appeal the Affordable Care Act if elected President, opting for free market tactics in the health insurance industry – allowing individuals and employers to continue to opt in or out of privately offered health insurance. The Republican Candidates promise to expand coverage, improve health care quality, lower drug and other medical costs, and even increase transparency in the health care market [https://ballotpedia.org/2016_presidential_candidates_on_healthcare].
Meanwhile on the other end of the political spectrum, Democratic Candidate Bernie Sanders goes so far as to say that he wants to expand the ACA into a Medicaid-for-all system, which could completely remove employer-sponsored health care from the equation. Democratic Candidate Secretary Hillary Clinton has been an advocate of universal health care ever since she proposed her own health care reform plan in the 90’s and is now running with the intention of defending and building upon the ACA. In an interview with AOL.com on January 27, 2016, she expressed that
“Health care is a basic right. We are 90 percent covered, we gotta get to 100 percent, and then we gotta get cost down and make it work for everybody. And even though we didn't get it then, we've got it now and I'm going to defend it and improve it" [https://ballotpedia.org/2016_presidential_candidates_on_healthcare].
There remains a lot of uncertainty as to Uncertainty surrounds the specific effects effect of the ACA on small businesses because of the many delays and exemptions in the rollout process and implantation of the ACA’s mandates and provisions. By extrapolating from Considering the status quo and general trends of the health insurance market, the ACA seems it will most likely not turn out not to be the “job-killer” or “enemy of small business” it was predicted to be. And largely, there is while insurance premiums will continue to rise for the firms, which have to provide employer-sponsored health insurance to its employees, the bill should not significant evidence signaling that the ACA is devastating seriously harm small businesses and startups with fewer than 50 full time equivalent employees.
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<onlyinclude>[[Image:obama's signature.jpg|225px|right]] The Patient Protection and Affordable Care Act was passed by Congress and signed into law by President Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act Amendmentof 2010, the law completely replaced the existing health care system in the United States, by expanding Medicaid and Medicare, and mandating all individuals to sign up for health insurance coverage through a Qualified Health Plan (QHP's must be offer affordable and comprehensive coverage - either privately or publicly funded). Here is a link to the complete text of the [http://obamacarefacts.com/wp-content/uploads/2014/10/obamacarebill.pdf PPACA and the Health Care and Education Reconciliation Act].
One concern with the Patient Protection and [[Affordable Care Act]] is that “Obamacare” will kill [[Small Business]] [http://www.investors.com/liberal-study-finds-obamanomics-killed-the-american-entrepreneur/]. Obamacare's effect on small businesses is not necessarily seen in the abandonment of plans to grow businesses or death of businesses themselves, but rather, in a slowing or halting in hiring, as well as a cut in employees hours. According to a Gallup and Wells Fargo survey of 600 small business owners conducted in 2012, 48% of small business owners point toward "potential healthcare costs" as a reason for not hiring more employees [http://www.gallup.com/poll/152654/health-costs-gov-regulations-curb-small-business-hiring.aspx].
Furthermore, while the cost of insurance premiums and plans have assuredly risen post-ACA, health insurance premiums have been increasing due to rising health care costs for many years (prior to the act's enactment) [http://obamacarefacts.com/obamacare-small-business/] [http://jhppl.dukejournals.org/content/36/3/539.short].
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=='''The ACA and Small Business'''==
The Affordable Care Act uses the terminology “full-time equivalent” (abbreviated FTE) when calculating the number of full-time employees.
The employer mandate of the ACA applies to relatively larger small businesses - firms with greater than 50 FTE employees - but many of these larger businesses offer health insurance coverage for their employees already.
=='''Small Businesses with Fewer than 50 FTE'''==
If employers with fewer than 50 FTE find themselves unable or unwilling to accommodate the rising costs of health care, they can simply opt out of providing employer-sponsored health insurance. Those who do decide to provide employer-sponsored health insurance will face the rising premiums and increased regulation, as a result of the ACA's minimum standards for Qualified Health Plans (increased comprehensiveness and affordability).
===Regulations on Health Care Coverage===
===Increased Marginal Cost for 50th Employee===
Small businesses with fewer than 50 FTE are exempt from the penalties of ACA; however, as soon as a company reaches the 50th employee mark, the hire becomes much more expensive, potentially dis-incentivizing small businesses from expanding their labor force.
SHOP allows for increased employer choice functions, enabling employers to choose from a larger pool of available coverage options for employees [http://digital.library.unt.edu/ark:/67531/metadc501935/m1/1/high_res_d/R43181_2015Jan15.pdf] The financial advantage of purchasing insurance trough the SHOP exchanges is uncertain, as insurers in the marketplace cannot charge premiums based on health status, and workers using the SHOP exchanges, will become ineligible for subsidies when they buy their own insurance [http://www.ncpa.org/pub/st356]. What SHOP does offer small businesses is increased buying power in the group-plan market (an advantage only larger firms used to possess) and a simpler way to compare prices, coverage, and quality of plans [http://obamacarefacts.com/insurance-exchange/shop-exchange/].
===Small Employer Health Insurance Tax Credit===
There is also a temporary health insurance tax credit available to firms with 25 or fewer employees and making less than $50,000 in annual wages. However, but many firms do not meet the strict requirements necessary for obtaining the tax credit that would cover up to 50% of employer contributions to employees' health insurance premiums (up to 35% for tax-exempt employers):
*1) Firms must employ fewer than 25 full-time equivalent (FTE) employees*Average 2) Have an average employee salary of less than $50,000 per year or less (adjusted for 2014 inflation rates)*3) Employer coverage of must pay for at least 50% of all FTE employees' premium costs *4) Employee Coverage for FTE employees' must be through Qualified Health Plans must be , purchased through the SHOP Marketplace*5) Only employers with 10 or fewer FTE with annual wages of less than $10,000 can qualify for the full tax credit ( "the smaller the business, the bigger the credit" [https://www.healthcare.gov/small-businesses/provide-shop-coverage/small-business-tax-credits//]) (After 2014, the maximum credit amount increases from 35% to 50% of employers' share of premiums*6) Employers cannot claim the tax credit for more than two consecutive and taxable years (starting in the first taxable year after 2014)
The health insurance tax credit became available to firms in 2014 [http://obamacarefacts.com/insurance-exchange/shop-exchange/]. After 2014, the maximum credit amount increases from 35% to 50% of employers' share of premiums. The tax credit is quite under-inclusive, though, and according to the National Federation of Independent Businesses, only one in three small businesses qualify [http://www.ncpa.org/pub/st356]. Of the estimated 1.4 to 4 million small businesses that were eligible for the wide range of tax credits, only 181,000 actually claimed the Small Employer Health Insurance Tax Credit in 2014.
According to Holly Wade, the director of research and policy analysis for the NFIB Research foundation, "the small business tax credit is a better talking point than it is a financial incentive for small businesses" [http://www.bizjournals.com/bizjournals/washingtonbureau/2016/03/why-obamacares-tax-credits-failedsmall-businesses.html].
=='''Conclusion'''==
In fact, the head of the CBO Douglas Elmendorf said, “We don’t think that the healthcare law is having a significant impact on the economy today… It would reduce the amount of labor used in the economy by about a half a percent at the end of the decade… but, most of that is people choosing not to work because they can obtain health insurance at an affordable price outside of the workforce” [http://obamacarefacts.com/obamacare-small-business/]. John Arensmeyer, founder and CEO of the Small Business Majority, in a statement reported by Fox News, said that
15. [https://ballotpedia.org/2016_presidential_candidates_on_healthcare Ballotpedia]
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